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The researchers associated increases in multidrug-resistant MRSA in the hospital with excessive use of two specific classes of antibiotics often prescribed to treat pneumonia (fluoroquinolones) and offered as a substitute for patients allergic to penicillin (macrolides).

"Patients and doctors should work together to reduce the number of unnecessary antibiotic prescriptions by not taking or prescribing antibiotics to treat viral illness, such as colds and flus," said in a statement Ramanan Laxminarayan, the lead author of the study. He noted previous research showing that up to one million antibiotic prescriptions each year are given out when not needed.

Laxminarayan emphasized the importance of seasonal flu vaccines as a preventive measure against both illness and unnecessary prescribing and consumption of antibiotics.

Community-acquired antibiotic resistance becomes a problem when patients who use antibiotics frequently for mild illnesses require therapy for more serious conditions, such as infections that develop as a result of surgery or cancer-related complications. It affects the general population by introducing into the environment evolved germs such as MRSA and VRSA, also known as "superbugs."

"The cost of [antibiotic] consumption, aside from the price of the drug itself, is borne by future generations, who because of resistance will have fewer options for treating infectious diseases," the study states.

In the U.S., more than 63,000 patients die every year from hospital-acquired infections that are resistant to at least one antibiotic. The economic costs are staggering: in 2004, the Pennsylvania Health Care Cost Containment Commission estimated that Medicare was billed at least $20 billion for the treatment of hospital-acquired infections.

The study found that even in moderate cases, patients have to be given a higher dose of drugs in order for the treatment to be effective. For example, as of 2002 the annual national cost for treating ear infections had risen by an estimated 20 percent, or $216 million.

But the spread of antibiotic resistance is not only the fault of demanding patients and obliging or irresponsible physicians. They can share the blame with insurance companies that price their individual policies out of reach for most uninsured Americans, but continue to reimburse patients for antibiotic treatment regardless of whether it is warranted. Klein says pharmaceutical firms that benefit from antibiotic sales and thus have few incentives to manage the problem also contribute.

"Who's ultimately responsible is very difficult to determine in our health care system, but that allows for a great role for health policy makers to play."

The report is part of a project by the non-profit Center for Disease Dynamics, Economics & Policy to evaluate the growing problem of antibiotic resistance in the U.S. and propose public policy responses. It is the result of contributions by researchers at Resources for the Future, the University of Chicago, the National Institutes of Health, and Emory University, and was funded in part by the Robert Wood Johnson Foundation.